Pelvic angiography is effective for emergency pediatric patients with pelvic fractures: a propensity-score-matching study with a nationwide trauma registry in Japan

Abstract

Purpose The aim of this study was to evaluate the association between the implementation of pelvic angiography (PA) and outcome in emergency pediatric patients with pelvic fracture. Methods We extracted data on pelvic fracture patients aged ≤ 19 years between 2004 and 2015 from a nationwide trauma registry in Japan. The main outcome was hospital mortality. We assessed the relationship between implementation of PA and hospital mortality using one-to-one propensity-score-matching analysis to reduce potential confounding effects in comparing the PA group with the non-PA group. Results In total, 1351 patients were eligible for our analysis, with 221 patients (16.4%) included in the PA group and 1130 patients (83.6%) included in the non-PA group. For all patients, the proportion of hospital mortality was higher in the PA group than in the non-PA group [13.6% (30/221) vs 7.1% (80/1130), crude odds ratio (OR) 2.062 (95% confidence interval (CI), 1.318-3.224); p = 0.002]. In the propensity-score-matched patients, the proportion of hospital mortality was lower in the PA group than in the non-PA group [10.5% (22/200) vs 18.2% (38/200), p = 0.027]. This finding was confirmed in both the multivariable logistic regression model [adjusted OR 0.392 (95% CI, 0.171-0.896); p = 0.026] and the conditional logistic regression model [conditional OR 0.484 (95% CI, 0.261-0.896); p = 0.021]. Conclusion The implementation of PA was significantly associated with lower hospital mortality among emergency pediatric patients with pelvic fractures compared with the non-implementation of PA.

Sex and age differences in isolated traumatic brain injury: a retrospective observational study

“…Furthermore, we excluded patients with a maximum head AIS score of 6 (lethal injury) or 9 (unspecified injury); cardiopulmonary arrest on hospital arrival; a requirement for inter-hospital transport [ 8 , 9 ]; or missing data for variables required for the logistic regression analysis. Cardiopulmonary arrest was defined as a systolic blood pressure of 0 mmHg and/or heart rate of 0 bpm [ 10 ].…”

Use of Vasopressors Increases the Risk of Mortality in Severe Traumatic Brain Injury: A Nationwide Retrospective Cohort Study in Japan

“…We also excluded cases with missing outcome data or variables required for propensity score (PS) matching [13,14]. This study de ned patients in cardiopulmonary arrest as those whose systolic blood pressure was 0 mmHg and/or heart rate was 0 bpm on or before hospital arrival [15].…”

“…The physicians and medical assistants who attended the AIS coding course were the main inputters of the data [15,16]. The JTDB records trauma patient data including age; sex; mechanism of injury; AIS code (1998 version); Injury Severity Score (ISS); vital signs on hospital arrival; date and time series from hospital arrival to discharge; medical treatments such as interventional radiology, surgery, and computed tomography; complications; and mortality on discharge [15,16]. ISS was calculated from the top three AIS scores in nine sites classi ed using the AIS codes.…”

Association of vasopressor use with mortality in severe traumatic brain injury: a nationwide retrospective cohort study in Japan

“…We also excluded cases with missing outcome data or variables required for propensity score (PS) matching [13,14]. This study de ned patients in cardiopulmonary arrest as those whose systolic blood pressure was 0 mmHg and/or heart rate was 0 bpm on or before hospital arrival [15].…”

“…The JTDB was launched in 2003 by the Japanese Association for the Surgery of Trauma (Trauma Surgery Committee) and the Japanese Association for Acute Medicine (Committee for Clinical Care Evaluation) [15,16], similar to the trauma databases in North America, Europe, and Oceania. By 2018, 272 major emergency medical institutions across Japan had been registered in the JTDB database [16].…”